Diabetes and anaesthesia

Re: Diabetes and anaesthesia

Ernesto Hernandez — Fri, 08 May 2009 18:57:36 GMT

Hi Antonio

I've just done the same op that you plan to do

I usually don't use antibiotics as I checked an urine sample which was clear of infection, and I don't routinely use antibiotics for bitch spays.

I usually had them in in the morning having had no insulin or food, and check a blood glucose level. If this level is no higher that 20mmol/l, I then use a saline drip. If it's higher, then need to use insulin and a glucose drip. Then premed with buprenorphine and low dose ACP and and NSAID, induce with propofol and anaesthesia with isoflurane in oxygen. I advise 1/2 dose of insulin and full meal in the evening (providing that the dog has eaten her meal) and then back to normal routine the following day.

I hope this helps

Cheers

Re: Diabetes and anaesthesia

Kevin Castle — Thu, 02 Apr 2009 17:14:28 GMT

I agree with you, fluroquins would be better kept in reserve. No offence taken

Re: Diabetes and anaesthesia

john kidman — Thu, 02 Apr 2009 15:51:53 GMT

Can I suggest not using a fluroquinolone. These should be avoided as first line antibiotics - especially when they are being given for a potential infection (no clinical signs have been mentioned). Articles regularly appear in the press about the overuse of antibiotics by the veterinary profession; mainly aimed at the farming industry and mainly revolving around the use of fluroquinolones and cephalosporins as these are also used in human medicine and there are concerns about the development of resistant strains. We should all be seen to have a responsible attitude to dispensing antibiotics and where possible dispense according to a culture and sensitivity profile. Whilst I don't disagree that a course of antibiotics may be a wise idea in an unstable diabetic about to undergo an anaesthetic, in my opinion a different antibiotic should be used (clav/amoxycillin a good suggestion). I hope this helps and it doesn't sound too much like I'm on my soap box!!

Re: Diabetes and anaesthesia

Kevin Castle — Mon, 30 Mar 2009 19:02:01 GMT

Yes that's fine, or clav/amoxycillin. I personally prefer marbofloxacin to enroflox.

Re: Diabetes and anaesthesia

R. Antonio La Greca — Mon, 30 Mar 2009 17:21:12 GMT

Thank you very much for your advice Kevin.

As antibiotic do you think it's a good idea the use of Enrofloxacin?

Re: Diabetes and anaesthesia

Kevin Castle — Mon, 30 Mar 2009 15:52:37 GMT

I usually give pre-op antibiotics starting one or two days before (diabetics often have UTI or such like present), give half the normal dose of Insulin on the morning of the surgery, give IV fluids of saline on the day, premed with NSAID/opiod/ and reduced dose ACP. We use propofol and maintain with Isoflurane, making sure body temp etc is maintained well during surgery. This approach has always worked and never had any hiccups. Send home with post-op pain relief to reduce pain-induced stress and to encourage eating.

Hope this helps

Re: Diabetes and anaesthesia

R. Antonio La Greca — Mon, 30 Mar 2009 15:26:49 GMT

You are right Kevin!

Biochem and haematology are normal. Current therapy is Caninsulin 1UI/kg twice day S.C. (she is 8.5 Kg) and she has been on W/d for three weeks. I'd like to do an OVH because I suppose that the poor effect of Caninsulin is due to an ormonal action.

All the best

Re: Diabetes and anaesthesia

Kevin Castle — Mon, 30 Mar 2009 14:46:41 GMT

I would like a bit more information first - other biochem and haematology parameters, current therapy and what's the anaesthesia for?

Regards

Kevin